Recent advances in the treatment of knee osteoarthritis with leg brace
Leg brace is rarely used in treating knee osteoarthritis in China.As a simple, safe and effective conservative treatment strategy for knee osteoarthritis, knee arthroplasty has been widely used in developed countries in Europe and America, and is regarded as an important part of non-drug therapy for knee osteoarthritis.The basic principle of the knee brace in the treatment of single compartment osteoarthritis of the knee is to reduce the biomechanical weight of the knee joint involved compartment, reduce the pain and unstable feeling of the patient, so as to achieve the purpose of reducing symptoms and improving functions of the patient, and thereby improving the quality of life.
Leg braces reduce the biomechanical load on the knee joint's involved compartment
The knee brace consists of a thigh brace, a calf brace, a unilateral knee hinge, and a kneecap compression pad.The knee compression pad exerts a corrective force on the deformity and produces a counterforce at the end edge of the femoral and calf supports, forming a typical three-point force correction system to correct the force line of the lower limbs.Studies have shown that a properly designed knee brace can shorten the adduction moment of the affected limb and reduce the weight load of the ventral inquisition, so it can significantly reduce the patient's pain and improve the function of the affected knee.Of the nine guidelines for the treatment of osteoarthritis of the knee, eight recommended the use of knee arthroplasty to relieve clinical symptoms and improve knee function.Recently Pollo et al. treated patients with medial compartment osteoarthritis of the knee with valgus, and found that compared to the patients who did not use braces, braces can reduce the burden of the lateral compartment by up to 17 percent.Kevin et al. applied eversion torque to the knee joint through leg brace, and found that for every 1Nm of eversion torque increase, the peak value of adduction torque decreased by 3%, while the peak value of medial compartment stress decreased by 1%, forming a linear relationship.Brouwer et al. conducted multi-center randomized controlled study on 117 patients with knee osteoarthritis, and found that the use of knee arthroplasty can improve pain symptoms and knee joint function in patients with knee osteoarthritis, and the walking distance of patients was significantly longer than that of the control group.In this study, 22 patients with varus deformity were also included, and the treatment group was divided into the varus group and the valgus group.Subgroup analysis showed that patients in the varus group had better curative effect, and patients with severe knee osteoarthritis and those younger than 60 years old had better curative effect.Knee arthroplasty with varus or varus correction is superior to hinge-only brace in the treatment of knee osteoarthritis.
2.Leg braces can relieve unstable feelings in patients
Some knee osteoarthritis patients often have knee uncertainty (such as the lateral collateral ligament injury and injury of anterior cruciate ligament tear cartilage wear and disappear after cause deputy ligament relaxation), Fitzgerald, etc. A survey, found in 105 cases of knee osteoarthritis patients, 63% of patients with knee stability not frequently in daily activities, while 44% of patients don't think this kind of stability affected the function of the knee joint.Krohnnu believes that the knee brace improves proprioception and provides mechanical support that significantly reduces the instability that accompanies osteoarthritis of the knee.
3.Indications, contraindications and complications of the use of braces
The first indication of leg brace application is mild to severe pain and swelling caused by osteoarthritis of the knee.Patients who require delayed knee replacement may also use a knee brace.The contraindication was marked by a significant change of bilateral interlocular osteoarthritis of the tibial femoral joint or severe knee instability.In patients with osteoarthritis of the knee of the medial panum, valgus should not be used if there is injury of the medial collateral ligament or other medial or medial structures or relaxation caused by chronic lesions.Similarly, varus should not be used in the presence of lateral collateral ligaments or other damage to the lateral or posterolateral structures or chronic lesions in patients with knee osteoarthritis of the lateral compartment.However, patellofemoral joint involvement should not be considered as contraindication.
